Medicare Compliance Advisor: Grievances & Privacy

Centene Corporation; East Windsor Hill (CT); Hybrid; USD 88,000 - 158,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Corporation seeks a subject-matter expert to support day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and regulations. You will translate regulatory guidance for business stakeholders, manage risk assessments, and assist in audit readiness and corrective actions across multiple lines of business.

This role partners with leadership to ensure timely completion of assignments and consistent documentation of compliance risks, trends, and

Qualifications

• Bachelor’s degree in a related field or equivalent experience required.
• Master’s Degree or Juris Doctor preferred.
• 5+ years Compliance, regulatory, operations, or risk management within a regulated industry.
• 4+ years Compliance advisory experience including regulatory research and drafting guidance.
• 2+ years experience supporting managed care or Medicare programs.

Responsibilities

• Execute the Medicare Compliance Program to prevent, detect, and correct noncompliance and fraud/abuse.
• Translate complex requirements into clear guidance for stakeholders.
• Support regulatory reporting, attestations, and filings.
• Identify risks and recommend mitigation strategies.
• Lead or support root-cause analysis and corrective action plans.
• Support audit readiness and monitoring activities.
• Provide regulatory training and mentoring to stakeholders.
• Collaborate with cross-functional teams to improve compliance processes.

Skills

Regulatory knowledge

Regulatory research

Analytics

Documentation

Communication

Multi-tasking

Education

Bachelor's degree

Master's degree

Juris Doctor

CHC certification

Job description

Centene Corporation seeks a subject-matter expert to support day-to-day execution of the Medicare Compliance Advisory program in alignment with CMS requirements and regulations. You will translate regulatory guidance for business stakeholders, manage risk assessments, and assist in audit readiness and corrective actions across multiple lines of business.

This role partners with leadership to ensure timely completion of assignments and consistent documentation of compliance risks, trends, and